Top Occupational Therapists in Billings, Montana (2026)

Verified June 2026. Listings reflect publicly available information from provider websites and directories. Always confirm current services, availability, and insurance directly with the provider.

Occupational therapy helps children build the everyday skills that make childhood work — holding a pencil, managing big feelings, tolerating new textures, getting dressed, and navigating a busy classroom. Whether your child is working through sensory processing differences, fine-motor delays, feeding and food selectivity, autism, ADHD, dyspraxia, or self-regulation challenges, Billings is the occupational therapy hub for an enormous stretch of south-central Montana and the northern High Plains. As the state's largest city and its primary medical center — anchored by Billings Clinic and St. Vincent Healthcare (now part of Intermountain Health) — Billings draws families who may drive in from hundreds of miles away, because the next comparable concentration of pediatric specialists can be a long way off in any direction.

That geographic isolation is the defining feature of choosing care here. Billings has a genuinely strong but compact group of pediatric OT providers rather than a sprawling metro market, so demand is high and waitlists are common. To build this guide, we reviewed Billings-area occupational therapy practices and verified that each is currently operating, then captured the specialties, locations, and service models that matter most to families. This list includes all nine providers that met our verification bar — we did not pad it to a round number. The order below reflects breadth of services and accessibility, not a paid or scored ranking. Use it as a starting point, then call the practices that fit your child's needs and your insurance.

Top Occupational Therapy Providers in Billings, MT

How to Choose an Occupational Therapist in Billings

The "best" occupational therapist is the one who fits your child's specific needs, your schedule, and your budget — and in an isolated market like Billings, who has openings. Here's what to weigh:

• Check credentials. Look for a licensed occupational therapist (OTR/L) with a current Montana license. For specific needs, ask about extra training — for example, sensory integration, feeding, handwriting, or pediatric pelvic health.
• Match the specialty to the need. Sensory processing, handwriting, feeding, dyspraxia, and self-regulation are distinct focus areas. Ask whether the therapist regularly treats your child's specific concern.
• Ask about waitlists early. Because Billings serves such a large rural region, pediatric OT slots fill quickly. Call several clinics at once and get on more than one waitlist if your child needs care soon.
• Confirm insurance and cost up front. Verify in-network status, copays, visit limits, and whether prior authorization is required — or ask for a superbill if the practice is private-pay. Ask about Montana Medicaid and Healthy Montana Kids if they apply to your family.
• Consider the setting and the drive. Clinics with sensory gyms offer equipment; in-home OT brings therapy into real-life routines. For families living outside Billings, in-home options can make consistent care realistic.
• Trust the rapport. Your child should feel safe and engaged. Many practices offer a brief consultation — use it to gauge fit before committing.

Questions to ask during a consultation: What is your experience with my child's needs? How will you set and measure goals? How often are sessions, and for how long? How will you coach me at home? Do you offer in-home visits if we live outside Billings? What is your current waitlist?

Occupational Therapy Resources in Billings

• Montana Milestones / Part C Early Intervention (Billings ECI team) — Montana's birth-to-three program provides free developmental support and OT evaluations through the local Early Childhood Intervention (ECI) team serving the Billings area.
• Billings Clinic — Pediatric evaluations, multidisciplinary clinics, and developmental resources for families across south-central Montana.
• St. Vincent Healthcare (Intermountain Health) — A second major Billings medical center with pediatric and developmental services for the region.
• Montana Medicaid & Healthy Montana Kids (HMK) — Coverage for occupational therapy for eligible children, which can reduce out-of-pocket cost to a copay or to $0 for medically necessary care.
• Your child's school district (Billings Public Schools) — Public schools provide occupational therapy services through IEPs and 504 plans for eligible students.

Frequently Asked Questions

How much does occupational therapy cost in Billings, Montana?

Out-of-pocket pediatric occupational therapy in Billings typically runs about $110–$190 per session at private practices, with evaluations costing more, while hospital-affiliated programs such as Billings Clinic Pediatric Therapy may bill differently. Many Billings providers accept commercial insurance and Montana Medicaid, which can reduce your cost to a copay or to $0 for covered, medically necessary services. Because Billings is a smaller, isolated market with limited providers, ask about waitlists and confirm rates and coverage directly with each clinic.

Does insurance cover occupational therapy in Montana?

Many Montana health plans cover occupational therapy when it is medically necessary, and Montana Medicaid and Healthy Montana Kids (HMK) cover OT for eligible children. For children birth to age three, Montana's Part C Early Intervention program — known as Montana Milestones / Family Education and Support — provides services at little or no cost regardless of insurance. Coverage limits, prior-authorization rules, and visit caps vary by plan, so verify benefits before starting. Some Billings practices are private-pay only and can provide a superbill for out-of-network reimbursement.

What does pediatric occupational therapy help with?

Pediatric OT helps children build the skills they need for daily life: fine motor and handwriting skills, sensory processing and self-regulation, visual-motor integration, motor planning and coordination, feeding and food selectivity, and self-care tasks like dressing and bathing. OTs often support children with autism, ADHD, sensory processing differences, dyspraxia, and developmental delays.

How long are occupational therapy sessions for children?

Most pediatric OT sessions in Billings last 30 to 60 minutes, typically once or twice a week. Initial evaluations usually take 60 to 90 minutes. Frequency depends on the child's goals and the therapist's recommendation, and some clinics also offer in-home visits to fit therapy into real-life routines.

Do Billings occupational therapists offer in-home therapy?

Yes. Because families in south-central Montana can live hours from the nearest clinic, several Billings providers — including Advanced Therapy Clinic (OT delivered in-home), LEAF Pediatric Clinic (clinic plus in-home, with aquatic and equine options), and Wild Roots Therapy (clinic, group, and home consults) — offer flexible, in-home, or community-based delivery in addition to clinic-based care.

How do I know if my child needs occupational therapy?

Consider an OT evaluation if your child struggles with handwriting or fine motor tasks, is over- or under-sensitive to sensory input, has trouble with self-care like dressing or feeding, is a very selective eater, avoids age-appropriate play, or has difficulty with attention and self-regulation. For children birth to three, Montana Milestones can complete a developmental evaluation, and a pediatrician referral or direct evaluation can clarify whether OT would help an older child.

Find More Therapists in Billings

• Top Speech Therapists in Billings, MT
• Top Pediatric Physical Therapists in Billings, MT

Related Resources on DrSensory

• Browse Occupational Therapists by City
• Sensory Processing Disorder (SPD)
• Autism Spectrum Disorder (ASD)